- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05871476
Interventions to Decrease CRE Colonization and Transmission Between Hospitals, Households, Communities and Domesticated Animals (I-CRECT)
May 23, 2023 updated by: Pham-Duc Phuc, Hanoi University of Public Health
Interventions to Decrease Carbapenem Resistant Enterobacteriaceae Colonization and Transmission Between Hospitals, Households, Communities and Domesticated Animals
Carbapenem resistant Enterobacteriaceae (CRE) colonization of patients discharged from hospitals is a source of transmission to the community.
In a cluster randomized controlled trial the effect of a bundle of interventions will be assessed on CRE transmission from CRE+ index patient discharged from hospital to HouseHold (HH) members.
The districts in two provinces will be randomized to intervention or control.
An information, communication, education and hygiene intervention, developed in collaboration with local health authorities, will aim to improve hygiene and decrease antibiotic (AB) use.
The effect will be evaluated on CRE transmission between HH members, livestock and environment through consecutive CRE screening using fecal and hospital effluent samples cultured on carbapenem selective media.
Knowledge, Attitudes, Practice surveys with smartphones will assess health seeking, AB use and hygiene adherence, hence detecting the effect of interventions.
If transmission of CRE +/- Colistin Resistant Enterobacteriaceae (CoRE, common among livestocks) is detected the source will be investigated including livestock and food, targeted information will be given and evaluated.
In hospitals the effect of cohort care will be assessed on CRE acquisition, hospital acquired infection, treatment outcome, costeffectiveness and contamination in sewage water.
Mechanisms of resistance, relatedness of CRE isolates in different One Health departments, and rate of CRE transmission from humans to animals and vice versa, will be assessed through Whole Genome Sequencing (WGS).
Study Overview
Status
Recruiting
Study Type
Interventional
Enrollment (Estimated)
800
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Phuc Pham-Duc, MD, PhD
- Phone Number: +84 904049969
- Email: pdp@huph.edu.vn
Study Contact Backup
- Name: Viet-Linh Nguyen, BVetMed, PhD
- Email: vietlinh1603@gmail.com
Study Locations
-
-
Thai Binh
-
Thái Bình, Thai Binh, Vietnam, 06122
- Recruiting
- Thai Binh Pediatric Hospital
-
Contact:
- Thi Nhu Pham, MD
- Phone Number: 0986155211
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
- Child
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- All patients under 2 years old at the selected hospital are highly appreciated to join the study.
Exclusion Criteria:
- Patients not from the selected hospital and individuals outside the selected province
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Screening
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Intervention district
An information, communication, education and hygiene intervention, developed in collaboration with local health authorities, will aim to improve hygiene and decrease antibiotic use.
|
The intervention will focus on two main measurable outcomes: 1) Decrease feco-oral-animal transmission route to prevent in-HH and community spread of CRE +/- CoRE.
2) Decrease unindicated community use of ABs for humans and animals.
This WP focuses on a one health intervention in collaboration with local health authorities, developing and implementing an HH Education Communication Hygiene Intervention (HECHI) to improve HH hygiene and health management and reduce the risk of transmission between humans and animals, a Provider Engagement Intervention (PEI) to improve case management of common infection and decrease unindicated AB, and and a Livestock AB Intervention (LAI) to reduce the use of AB in livestock through improved biosecurity conditions and animal husbandry.
|
Active Comparator: cohort care at the hospital
A laminated note (yellow for "suspicious CRE carrier": green for (CRE-) patients and red for (CRE+) patients) should be put on the front of the patients' bed.
|
There will be 3 different cohort groups for the patients: 1) Unknown CRE colonisation status with increased barrier precautions (all patients until screening results arrive will belong to this group unless there are available screening results from referral hospital), 2) CREpos, and 3) CREneg.
CREpos patients (2) will be treated in one area of the ICUs by specially assigned nurses/personnel.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment the effectiveness of the hospital wastewater treatment on reducing CRE from hospital to community
Time Frame: 24 months from the starting of the project
|
The presence of CRE in hospital wastewater before and after treatment will be compared to evaluate the effectiveness of the treatment system on preventing the spreading of AMR to the community.
|
24 months from the starting of the project
|
Investigate the genetic relatedness of CRE isolates from hospital, household, animals, wastewater
Time Frame: 24 months from the starting of the project
|
The CRE isolated from rectal swab of patient admitted to hospital, household members, animals and wastewater will be subjected to Whole Genome Sequencing using Oxford MinION Nanopore/Illumina Miseq sequencing and bioinformatics analysis to investigate the mechanisms of resistance in different One-Health compartments.
|
24 months from the starting of the project
|
Change the prevalence of CRE colonisation
Time Frame: 12 months from the starting of recruitment patients
|
The intervention at hospital will lead to the reduction of CRE colonisation, hospital acquire infection, treatment duration and costs.
|
12 months from the starting of recruitment patients
|
Cheng th prevalence of CRE transmission in the household
Time Frame: 12 months from the starting of recruitment community participants
|
The Household Education Communication Hygiene Intervention expected to reduce the transmission of CRE from index patient to household member.
|
12 months from the starting of recruitment community participants
|
Change the awareness regarding AMR of local people
Time Frame: 18 months from the starting of recruitment community participants
|
The understanding on AMR, particularly of CRE, proper use of antibiotic for both humans and animals, will be improved.
This will be measured through the quantitative questionnaires.
|
18 months from the starting of recruitment community participants
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Mattias Larsson, MD, Karolinska Institutet
- Principal Investigator: Thirumalaisamy Velavan, PhD, University of Tübingen, Germany
- Study Director: Håkan Hanberger, Linköping University, Sweden
- Principal Investigator: Flavie Goutard, PhD, CIRAD, France
- Principal Investigator: Yaovi Mahuton Gildas Hounmanou, PhD, University of Copenhagen
- Principal Investigator: Minh-Dien Tran, Vietnam National Children's Hospital
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
July 1, 2022
Primary Completion (Estimated)
March 30, 2025
Study Completion (Estimated)
June 30, 2025
Study Registration Dates
First Submitted
May 4, 2023
First Submitted That Met QC Criteria
May 12, 2023
First Posted (Actual)
May 23, 2023
Study Record Updates
Last Update Posted (Actual)
May 25, 2023
Last Update Submitted That Met QC Criteria
May 23, 2023
Last Verified
May 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- JPIAMR 2021-195
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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